Music therapy anchored in Parkinson's treatment guidelines

12-06-2016. A new treatment guideline for Parkinson's disease (also: ideopathic Parkinson's syndrome) has been published in Germany under the umbrella of the Association of Scientific Medical Societies (AWMF). For the first time, music therapy treatment approaches such as gait training with music, therapeutic singing and group music therapy are listed as possible therapeutic options for this neurodegenerative disease.

The guideline thus takes into account the improved scientific evidence of music therapy. In the case of Parkinson's, this data is still very thin overall, even with the more established therapy methods such as physiotherapy, speech therapy and occupational therapy. Although all experts agree that regular therapy (such as physiotherapy and speech therapy) can have a favorable effect on the course of the disease, there is largely uncertainty about which therapy guarantees the best success for which type of course. This was recently demonstrated in a large-scale therapy study from England. The work presented by Clarke and colleagues in January 2016 describes the effects of a combination therapy of physiotherapy and occupational therapy over 3 months on 381 patients. This is a very high number of subjects for therapy studies, which is usually also suitable to find out subtle differences to an untreated control group. In this work, however, there were no positive effects of the therapies on the execution of everyday activities or the general quality of life. Such a result raises a number of questions: Was it the right therapy content? What role does the frequency of therapy play (an application of 2 weekly units was examined)? If the patient should have been preselected more, e.g. after tremor dominant or specific symptoms such as gait celebration? (Clarke et al. 2016, not included in S3 guideline)

Parkinson's therapy as a whole needs more specific and sophisticated approaches to clearly defined clinical problems. As a result, encouraging laboratory findings from new treatment approaches such as music therapy should be pursued more consistently and integrated into existing care. The new guideline of the AWMF has done this. With the listing as a possible treatment, the prescribing doctor now receives substantive and scientific backing. Of course, music therapy is still not billable because health insurance companies are not bound to refinance these services. Nevertheless, it is a step towards deeply anchoring music therapy in clinical treatment routines. Therapists and researchers are asked to support this with further empirical evidence.

S3 treatment guideline Parkinson of the AWMF (German)

Clarke, C, Patel, S, Ives, N, Rick, C, Dowling, F, Wooley, R, Wheatley, K, Walker, MF, Sackley, CM. (2016). Physiotherapy and Occupational Therapy vs No Therapy in Mild to Moderate Parkinson Disease. JAMA Neurol. doi: 10.1001 / jamaneurol.2015.4452

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